0001062993-22-005767.txt : 20220225
0001062993-22-005767.hdr.sgml : 20220225
20220225164005
ACCESSION NUMBER: 0001062993-22-005767
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20210413
FILED AS OF DATE: 20220225
DATE AS OF CHANGE: 20220225
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Martin Steven B.
CENTRAL INDEX KEY: 0001809217
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38961
FILM NUMBER: 22681005
MAIL ADDRESS:
STREET 1: 3055 LEBANON PIKE
STREET 2: SUITE 1000
CITY: NASHVILLE
STATE: TN
ZIP: 37214
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Change Healthcare Inc.
CENTRAL INDEX KEY: 0001756497
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374]
IRS NUMBER: 822152098
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0331
BUSINESS ADDRESS:
STREET 1: 424 CHURCH STREET, SUITE 1400
CITY: NASHVILLE
STATE: TN
ZIP: 37219
BUSINESS PHONE: 615-932-3000
MAIL ADDRESS:
STREET 1: 424 CHURCH STREET, SUITE 1400
CITY: NASHVILLE
STATE: TN
ZIP: 37219
FORMER COMPANY:
FORMER CONFORMED NAME: HCIT Holdings, Inc.
DATE OF NAME CHANGE: 20181019
4/A
1
form4a.xml
AMENDED STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
X0306
4/A
2021-04-13
2021-11-15
0001756497
Change Healthcare Inc.
CHNG
0001809217
Martin Steven B.
C/O CHANGE HEALTHCARE INC.
424 CHURCH STREET, SUITE 1400
NASHVILLE
TN
37219
0
1
0
0
EVP, Enterprise Technology
Common Stock
2021-04-13
4
F
0
9355
22.48
D
252813
D
Common Stock
2021-06-17
4
F
0
5399
23.07
D
247414
D
Represents a previously unreported withholding of shares in connection with previous vesting of RSUs. Reflects securities beneficially owned following the reported transaction as of the date of filing.
The Form 4 filed on November 15, 2021, is being amended to correct the amount of securities beneficially owned following the reported transaction. The amount of securities beneficially owned following the reported transaction reflects the current balance as of the filing date.
Exhibit List: Exhibit 24 - Power of Attorney
/s/ Robert Zachary Beasley, as Attorney-in-Fact
2022-02-25
EX-24
2
exhibit24.txt
POWER OF ATTORNEY
POWER OF ATTORNEY
Know all by these presents that the undersigned, does hereby
make, constitute and appoint each of Loretta Cecil, Robert
Zachary Beasley and Elizabeth Way, or any one of them, as a true
and lawful attorney-in-fact of the undersigned with full powers
of substitution and revocation, for and in the name, place and
stead of the undersigned (in the undersigned's individual
capacity), to execute and deliver such forms that the
undersigned may be required to file with the U.S. Securities and
Exchange Commission as a result of the undersigned's ownership
of or transactions in securities of Change Healthcare Inc. (i)
pursuant to Section 16(a) of the Securities Exchange Act of
1934, as amended, including without limitation, statements on
Form 3, Form 4 and Form 5 (including any amendments thereto) and
(ii) in connection with any applications for EDGAR access codes,
including without limitation the Form ID. The Power of Attorney
shall remain in full force and effect until the undersigned is
no longer required to file Forms 3, 4 and 5 with regard to his
or her ownership of or transactions in securities of Change
Healthcare Inc., unless earlier revoked in writing. The
undersigned acknowledges that Loretta Cecil, Robert Zachary
Beasley and Elizabeth Way are not assuming any of the
undersigned's responsibilities to comply with Section 16 of the
Securities Exchange Act of 1934, as amended.
By: /s/ Steven B. Martin
Name: Steven B. Martin
Date: February 2, 2022